Purro Birik - 6

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Purro Birik - (Healthy Spirit)



4.2 The Current Policy Context


The project brief identifies four documents are:

  • policy documents as the context for completing the project. The four Ways Forward, The National Consultancy Report on Aboriginal and Torres Strait Islander Mental Health (Swan and Raphael 1995);

  • Achieving Improved Aboriginal Health Outcomes: An Approach to Reform (Victorian Department of Human Services and Victorian Aboriginal Community Controlled Health Organisation, 1996);

  • Agreement on Aboriginal and Torres Strait Islander Health (Victorian Minister for Health, Commonwealth Minister of State for Health and Family Services, Aboriginal and Torres Strait Islander Commission, and Victorian Aboriginal Community Controlled Health Organisation 1996); and

  • Victoria's Mental Health Service Framework for Service Delivery (Victorian Mental Health Branch 1994)

Ways Forward, The National Consultancy Report on Aboriginal and Torres Strait Islander Mental Health written by Pat Swan and Beverley Raphael in 1995, has laid much of the foundation for the discussion that has occurred through the Purro Birik consultations.


Endorsed by the National Aboriginal Community Controlled Organisation (NACCHO), the report outlines the following guiding principles. 

  • The Aboriginal concept of health is holistic and encompasses mental, physical, social, cultural and spiritual health.

  • Self-determination is central.

  • Culturally valid understanding must shape the provision of services.

  • Experiences of trauma and loss are major factors contributing to impairment of health and wellbeing.

  • Human rights of Aboriginal people must be recognised and respected.

  • Racism, stigma, environmental adversity and social disadvantage have a negative ongoing impact on health and wellbeing.

  • Family and kinship are central.

  • There is no single Aboriginal and Torres Strait Islander culture or group.

  • Aboriginal people have great strengths.

Achieving Improved Aboriginal Health Outcomes: An Approach to Reform is an agreement signed in August 1996 between the Secretary, Victorian Department of Human Services; the Director, Public Health, Victorian Department of Human Services; and the Chairperson and Deputy Chairperson of VACCHO.


The document sets out a reform strategy based on improved planning processes which recognise the fundamental importance of community control, and cooperation between State and Commonwealth Governments and VACCHO (as the peak organisation for Victorian Aboriginal community controlled organisations).


The agreement supports the provision of a broad range of preventative and primary care health services through a Statewide network of Aboriginal community controlled agencies which have adequate resources, capacity and infrastructure to deliver these services. The agreement also recognises the importance of effective working partnerships between Aboriginal and mainstream services on the local community level to enhance the response from mainstream services to Aboriginal people.


The Agreement on Aboriginal and Torres Strait Islander Health between the Victorian Minister for Health, the Commonwealth Minister for Health and Family Services, ATSIC and VACCHO (signed in October 1996) aims to improve coordination of local and regional planning by Commonwealth and State Government and Aboriginal community controlled organisations.


The agreement outlines a commitment to improving access, quality and cultural sensitivity of mainstream services by establishing appropriate planning partnerships and training programs; establishing appropriate data collection protocols; and specifying the roles and responsibilities of the partners within the agreement.


The agreement clarifies that Aboriginal community control is the culturally valid process for delivering Aboriginal specific health services, and that it is appropriate for community controlled organisations to retain control over the design and delivery of the services they are funded to provide (in light of agreed outcomes).


The role of VACCHO in service planning and development is set out in section 4.4 of the agreement. This section refers to VACCHO:

  • establishing community principles, values and processes for planning and priority setting;

  • jointly participating in planning processes with Commonwealth and State Government departments;

  • leading and monitoring policy development on behalf of community controlled organisations;

  • promoting links between community controlled organisations;

  • providing information on health programs and policies to community controlled organisations; and

  • advising on and undertaking research, including the development and management of data collection within community controlled organisations.

Victoria's Mental Health Service Framework for Service Delivery released in March 1994 was the blueprint for the current organisation of public mental health services in Victoria. The document provided the direction for the shift from an institution-based mental health service system to one that emphasises community-based service delivery.


The public mental health system in 1999 is based on a system of integrated area networks of community and inpatient services. There are 21 adult area mental health services, 17 aged persons mental health services, and 13 child and adolescent mental health services, all of which are arranged into catchments that cover the entire state. In addition, 76 psychiatric disability support services provide day programs, residential rehabilitation, planned respite, home-based outreach support, and mutual support and self-help programs.


There are a number of statewide specialist services provided, which include forensic psychiatry, neuropsychiatry, brain trauma services, services for people with severe personality disorders, services for people who have eating disorders, and mother/baby services.


The Framework document defines processes for access to mental health services; priority for serious mental illness; treatment close to home in least restrictive environments; and the requirement for minimum interference with the rights, dignity and self-respect of consumers.


These four documents essentially provide the starting point for the Purro Birik project, and need to be understood to ensure the project builds on the existing agreements which have been established, and takes the most appropriate directions on service development issues.


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